No office rate
Choose 19340 when the implant is placed during the mastectomy operation. Choose 19342 for implant insertion or replacement in a separate session.
On this page
CMS RVU26D · Effective 2026-10-01
19340 in Merced
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$703.83
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Breast reconstruction
About 19340: Immediate breast implant reconstruction
Reports direct placement of a breast implant during the mastectomy operation for immediate reconstruction, rather than staged reconstruction with a tissue expander.
A surgeon places a breast implant during the same operative session as a mastectomy to create an immediate breast reconstruction. This approach may follow mastectomy for breast cancer or risk reduction. Plastic surgeons commonly perform the reconstruction, sometimes with a breast surgeon performing the mastectomy, in a hospital or ambulatory surgical setting. The implant is placed directly; a tissue expander is not used as the initial reconstructive device.
Report 19340 for immediate implant placement, with the mastectomy coded separately when performed. The operative report should identify the mastectomy session, laterality, reconstructive purpose, and implant placement. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 identifies bilateral surgery, paid at 150%. Assistant-at-surgery payment is statutorily restricted; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 19340
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU10.22 · 49%
- Practice expense (office) RVU8.76 · 42%
- Malpractice RVU2.01 · 10%
1.4K
Medicare services in 2024 · #2718 by national volume
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
19340 compared with similar codes
Office rates for Merced, from the same CMS release.
No office rate
19357 is for placement of a tissue expander as a staged reconstructive step; 19340 is for direct implant placement during mastectomy.
No office rate
19325 describes breast augmentation with an implant, rather than implant reconstruction performed in the mastectomy session.
The same code, a different location
How does Merced compare?
19340 across payment areas
Same release and payment basis · bars start at $0
Merced · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Madera
California · 19340
Office
Unavailable
Facility
$703.83
No comparable office rate is available.
Modesto
California · 19340
Office
Unavailable
Facility
$703.83
No comparable office rate is available.
Napa
California · 19340
Office
Unavailable
Facility
$782.60
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 19340
Office
Unavailable
Facility
$738.58
No comparable office rate is available.
Redding
California · 19340
Office
Unavailable
Facility
$703.83
No comparable office rate is available.
Rest Of California
California · 19340
Office
Unavailable
Facility
$703.83
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 19340
Office
Unavailable
Facility
$725.45
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 19340
Office
Unavailable
Facility
$729.92
No comparable office rate is available.
Salinas
California · 19340
Office
Unavailable
Facility
$727.04
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 19340
Office
Unavailable
Facility
$737.93
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 19340
Office
Unavailable
Facility
$817.16
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 19340
Office
Unavailable
Facility
$814.87
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 19340
Office
Unavailable
Facility
$836.81
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 19340
Office
Unavailable
Facility
$827.48
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 19340
Office
Unavailable
Facility
$716.41
No comparable office rate is available.
Santa Cruz-Watsonville
California · 19340
Office
Unavailable
Facility
$740.01
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 19340
Office
Unavailable
Facility
$728.06
No comparable office rate is available.
Santa Rosa-Petaluma
California · 19340
Office
Unavailable
Facility
$746.89
No comparable office rate is available.
Stockton
California · 19340
Office
Unavailable
Facility
$703.83
No comparable office rate is available.
Vallejo
California · 19340
Office
Unavailable
Facility
$779.31
No comparable office rate is available.
Visalia
California · 19340
Office
Unavailable
Facility
$703.83
No comparable office rate is available.
Yuba City
California · 19340
Office
Unavailable
Facility
$703.83
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 19340
Office
Unavailable
Facility
$779.19
No comparable office rate is available.
Miami
Florida · 19340
Office
Unavailable
Facility
$815.73
No comparable office rate is available.
Chicago
Illinois · 19340
Office
Unavailable
Facility
$791.88
No comparable office rate is available.
Manhattan
New York · 19340
Office
Unavailable
Facility
$809.67
No comparable office rate is available.
Alaska*
Alaska · 19340
Office
Unavailable
Facility
$860.64
No comparable office rate is available.
Alabama
Alabama · 19340
Office
Unavailable
Facility
$635.37
No comparable office rate is available.
Arkansas
Arkansas · 19340
Office
Unavailable
Facility
$627.27
No comparable office rate is available.
Arizona
Arizona · 19340
Office
Unavailable
Facility
$682.35
No comparable office rate is available.
Colorado
Colorado · 19340
Office
Unavailable
Facility
$709.20
No comparable office rate is available.
Connecticut
Connecticut · 19340
Office
Unavailable
Facility
$744.54
No comparable office rate is available.
Delaware
Delaware · 19340
Office
Unavailable
Facility
$692.50
No comparable office rate is available.
Fort Lauderdale
Florida · 19340
Office
Unavailable
Facility
$759.13
No comparable office rate is available.
Rest Of Florida
Florida · 19340
Office
Unavailable
Facility
$721.98
No comparable office rate is available.
Atlanta
Georgia · 19340
Office
Unavailable
Facility
$720.28
No comparable office rate is available.
Rest Of Georgia
Georgia · 19340
Office
Unavailable
Facility
$682.38
No comparable office rate is available.
Hawaii, Guam
Hawaii · 19340
Office
Unavailable
Facility
$712.91
No comparable office rate is available.
Iowa
Iowa · 19340
Office
Unavailable
Facility
$635.73
No comparable office rate is available.
Idaho
Idaho · 19340
Office
Unavailable
Facility
$642.30
No comparable office rate is available.
East St. Louis
Illinois · 19340
Office
Unavailable
Facility
$745.75
No comparable office rate is available.
Rest Of Illinois
Illinois · 19340
Office
Unavailable
Facility
$713.43
No comparable office rate is available.
Suburban Chicago
Illinois · 19340
Office
Unavailable
Facility
$763.20
No comparable office rate is available.
Indiana
Indiana · 19340
Office
Unavailable
Facility
$645.22
No comparable office rate is available.
Kansas
Kansas · 19340
Office
Unavailable
Facility
$639.70
No comparable office rate is available.
Kentucky
Kentucky · 19340
Office
Unavailable
Facility
$662.90
No comparable office rate is available.
New Orleans
Louisiana · 19340
Office
Unavailable
Facility
$692.95
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 19340
Office
Unavailable
Facility
$664.62
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 19340
Office
Unavailable
Facility
$764.46
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 19340
Office
Unavailable
Facility
$708.43
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 19340
Office
Unavailable
Facility
$743.82
No comparable office rate is available.
Rest Of Maryland
Maryland · 19340
Office
Unavailable
Facility
$702.50
No comparable office rate is available.
Rest Of Maine
Maine · 19340
Office
Unavailable
Facility
$652.30
No comparable office rate is available.
Southern Maine
Maine · 19340
Office
Unavailable
Facility
$673.68
No comparable office rate is available.
Detroit
Michigan · 19340
Office
Unavailable
Facility
$736.90
No comparable office rate is available.
Rest Of Michigan
Michigan · 19340
Office
Unavailable
Facility
$684.29
No comparable office rate is available.
Minnesota
Minnesota · 19340
Office
Unavailable
Facility
$662.31
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 19340
Office
Unavailable
Facility
$681.69
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 19340
Office
Unavailable
Facility
$687.17
No comparable office rate is available.
Rest Of Missouri
Missouri · 19340
Office
Unavailable
Facility
$658.96
No comparable office rate is available.
Mississippi
Mississippi · 19340
Office
Unavailable
Facility
$642.89
No comparable office rate is available.
Montana**
Montana · 19340
Office
Unavailable
Facility
$700.95
No comparable office rate is available.
North Carolina
North Carolina · 19340
Office
Unavailable
Facility
$657.25
No comparable office rate is available.
North Dakota**
North Dakota · 19340
Office
Unavailable
Facility
$661.21
No comparable office rate is available.
Nebraska
Nebraska · 19340
Office
Unavailable
Facility
$636.80
No comparable office rate is available.
New Hampshire
New Hampshire · 19340
Office
Unavailable
Facility
$704.69
No comparable office rate is available.
Northern Nj
New Jersey · 19340
Office
Unavailable
Facility
$773.97
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 19340
Office
Unavailable
Facility
$748.17
No comparable office rate is available.
New Mexico
New Mexico · 19340
Office
Unavailable
Facility
$690.29
No comparable office rate is available.
Nevada**
Nevada · 19340
Office
Unavailable
Facility
$690.17
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 19340
Office
Unavailable
Facility
$835.77
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 19340
Office
Unavailable
Facility
$758.34
No comparable office rate is available.
Queens
New York · 19340
Office
Unavailable
Facility
$805.86
No comparable office rate is available.
Rest Of New York
New York · 19340
Office
Unavailable
Facility
$666.52
No comparable office rate is available.
Ohio
Ohio · 19340
Office
Unavailable
Facility
$676.17
No comparable office rate is available.
Oklahoma
Oklahoma · 19340
Office
Unavailable
Facility
$654.81
No comparable office rate is available.
Portland
Oregon · 19340
Office
Unavailable
Facility
$721.84
No comparable office rate is available.
Rest Of Oregon
Oregon · 19340
Office
Unavailable
Facility
$679.98
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 19340
Office
Unavailable
Facility
$732.18
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 19340
Office
Unavailable
Facility
$673.40
No comparable office rate is available.
Puerto Rico
Puerto Rico · 19340
Office
Unavailable
Facility
$703.30
No comparable office rate is available.
Rhode Island
Rhode Island · 19340
Office
Unavailable
Facility
$709.98
No comparable office rate is available.
South Carolina
South Carolina · 19340
Office
Unavailable
Facility
$668.78
No comparable office rate is available.
South Dakota**
South Dakota · 19340
Office
Unavailable
Facility
$656.51
No comparable office rate is available.
Tennessee
Tennessee · 19340
Office
Unavailable
Facility
$643.38
No comparable office rate is available.
Austin
Texas · 19340
Office
Unavailable
Facility
$711.08
No comparable office rate is available.
Beaumont
Texas · 19340
Office
Unavailable
Facility
$669.98
No comparable office rate is available.
Brazoria
Texas · 19340
Office
Unavailable
Facility
$686.41
No comparable office rate is available.
Dallas
Texas · 19340
Office
Unavailable
Facility
$693.45
No comparable office rate is available.
Fort Worth
Texas · 19340
Office
Unavailable
Facility
$691.40
No comparable office rate is available.
Galveston
Texas · 19340
Office
Unavailable
Facility
$690.22
No comparable office rate is available.
Houston
Texas · 19340
Office
Unavailable
Facility
$727.01
No comparable office rate is available.
Rest Of Texas
Texas · 19340
Office
Unavailable
Facility
$679.65
No comparable office rate is available.
Utah
Utah · 19340
Office
Unavailable
Facility
$676.68
No comparable office rate is available.
Virginia
Virginia · 19340
Office
Unavailable
Facility
$676.37
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 19340
Office
Unavailable
Facility
$703.30
No comparable office rate is available.
Vermont
Vermont · 19340
Office
Unavailable
Facility
$664.99
No comparable office rate is available.
Rest Of Washington
Washington · 19340
Office
Unavailable
Facility
$704.98
No comparable office rate is available.
Seattle (King Cnty)
Washington · 19340
Office
Unavailable
Facility
$772.29
No comparable office rate is available.
Wisconsin
Wisconsin · 19340
Office
Unavailable
Facility
$642.34
No comparable office rate is available.
West Virginia
West Virginia · 19340
Office
Unavailable
Facility
$691.69
No comparable office rate is available.
Wyoming**
Wyoming · 19340
Office
Unavailable
Facility
$683.63
No comparable office rate is available.
See how rates vary across the country
19340 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 19340 in Merced. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$774.21
$703.83 × 110% = $774.21
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 19340 in Merced.
PPRRVU2026_Oct_nonQPP.csv
1,697
- Code
- 19340
- Physician work
- 10.22
- Practice expense
- 8.76
- Malpractice
- 2.01
GPCI2026.csv
15
- Locality
- Merced
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.22 | × 1.017 | 10.3937 |
| Practice expense | 8.76 | × 1.096 | 9.6010 |
| Malpractice | 2.01 | × 0.536 | 1.0774 |
| Total RVUs | 21.0721 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Merced$703.83
Open 19340 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.22 | 1.017 |
| Practice expense | 8.76 | 1.096 |
| Malpractice | 2.01 | 0.536 |
(10.22 × 1.017 + 8.76 × 1.096 + 2.01 × 0.536) × $33.4009 = $703.83
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
19340 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $703.83 | RVU26D |
| 2026-07-01 | Not available in this setting | $703.83 | RVU26C |
| 2026-04-01 | Not available in this setting | $703.83 | RVU26B |
| 2026-01-01 | Not available in this setting | $703.83 | RVU26A |
| 2025-10-01 | Not available in this setting | $754.22 | RVU25D |
| 2025-07-01 | Not available in this setting | $754.22 | RVU25C |
| 2025-04-01 | Not available in this setting | $754.22 | RVU25B |
| 2025-01-01 | Not available in this setting | $754.22 | RVU25A |
19340 billing questions
How is 19340 different from 19342?
19340 describes implant placement in the same operative session as mastectomy. 19342 is used for implant insertion or replacement in a separate, later reconstruction session.
When is 19357 reported instead?
Use 19357 when the surgeon places a tissue expander as a staged step in breast reconstruction. Code 19340 describes direct implant placement during the mastectomy operation.
Is the mastectomy reported separately?
Yes. Report the applicable mastectomy procedure separately from the immediate implant reconstruction when both services are performed.
How should bilateral placement be reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. The operative documentation should support implant placement on both sides.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care. Related follow-up during that period is part of the global service.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is statutorily restricted. Co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,69419325,,Breast augmentation w/implt,A,,7.92,7.55,NA,7.55,,1.48,16.95,16.95,0,090,0.10,0.71,0.19,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69519328,,Rmvl intact breast implant,A,,7.25,6.72,NA,6.72,,1.40,15.37,15.37,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69619330,,Rmvl ruptured breast implant,A,,8.78,7.27,NA,7.27,,1.69,17.74,17.74,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69719340,,Insj breast implt sm d mast,A,,10.22,8.76,NA,8.76,,2.01,20.99,20.99,0,090,0.10,0.71,0.19,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69819342,,Insj/rplcmt brst implt sep d,A,,10.22,8.66,NA,8.66,,1.91,20.79,20.79,0,090,0.10,0.71,0.19,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,69919350,,Nipple/areola reconstruction,A,,8.88,16.21,,7.89,,1.67,26.76,18.44,0,090,0.10,0.71,0.19,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,70019355,,Correct inverted nipple(s),A,,8.31,14.53,,6.99,,1.53,24.37,16.83,0,090,0.10,0.71,0.19,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623